School health units expand in Southern Ky.; treatment and prevention should pay off in longer, healthier lives for students

By Melissa Patrick
Kentucky Health News

School-based health centers are a new approach to providing student health care through a public-private partnership, whose model of care has the potential to improve the lives of some students forever.

The units were created as a way to keep nurses in schools, during a time when school-nurse budgets and health department budgets are being slashed, as done recently in Lincoln County.

Kentucky has 15 such clinics, six of them operated by the Burkesville-based Cumberland Family Medical Center.

The CFMC Healthy Kids Clinics provide a wide range of care to its students, including acute care visits, well-care visits, school and sports physicals, flu clinics and immunizations, all during school hours.

“For those cases where typically the child would have to go home, like an earache, stomach bug, strep throat or flu, now those kids can be seen at school by the nurse practitioner or physician assistant,” Clarissa “Moochie” Hart, CFMC’s director of school-based services, said in an interview.

This model of easily accessible health care that focuses on prevention for all of these students has the potential to influence their health when they become adults. A recent study found that teens with unmet health care needs have poor health outcomes when they become adults, notes Stephen Feller of United Press International.

The study, published in the Journal of the American Academy of Pediatrics, analyzed data from the National Longitudinal Study of Adolescent to Adult Health and found that teens were 13 to 52 percent more likely to have “adverse adult health outcomes” if they had had unmet health care needs in adolescence, compared to those with no unmet need. This was found to be true regardless of the reason given for the unmet health care need.

“These findings reinforce the importance of early intervention and investment to improve adult health,” said the report.

How do the Healthy Kids Clinics work?

This year, CFMC expanded its Healthy Kids Clinics to Adair, Casey, Clinton, Cumberland, and Wayne counties after a successful pilot in Russell County last year. Now they serve almost 15,000 students in 26 Southern Kentucky schools.

Each school will continue to have a school nurse, paid for by the school district and CFMC, Hart said. The new feature is that four of the districts will have their own nurse practitioner and two of the smaller districts, Clinton and Cumberland, will share a physician assistant, all overseen by a physician.

This additional personnel, including a nurse assigned to help each of the nurse practitioners and the physician assistant, is paid for entirely by CFMC. It is able to sustain the program because it can bill the family’s private insurer, or the recently expanded federal-state Medicaid program for the poor, if the child is seen by a physician’s assistant or nurse practitioner.

If a school nurse decides a student needs that higher level of care, she calls the parent or legal guardian to get permission. “This is just an option,” Hart said. “The parents have the option of picking their kids up and taking them to their current medical provider.”

While students must have a signed consent form to be seen by any health-care provider in school, no care is to be given without the permission of the parent or guardian, who will be called every time care is recommended, Hart said.

If the student sees the nurse practitioner or the physician assistant, CFMC then bills that student’s insurance or Medicaid, which pays CFMC more than most providers because it is a Federally Qualified Health Center.

“We are not going to turn anybody away regardless of their ability to pay,” Hart stressed. “We are not in this to make money. This is a great service that keeps our kids healthy and hopefully changes the way that young people look at getting health care. We want to stress the importance of preventive care.”

Hart also noted that school-based health centers decrease student absences and helps parents avoid missing work.

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